> 4.0 ng/mL. Tumour aggressiveness was assessed according to serum PSA level, biopsy Gleason score and clinical stage in the subset of 216 patients with cancer (45.2%). We also compared prostate cancer risk and tumour aggressiveness in 80 hypogonadal patients (16.7%) and 398 eugonadal patients (83.3%). RESULTSThe median total serum testosterone level in patients without and with prostate cancer was 466.0 and 466.5 ng/dL, respectively ( P > 0.05); the median levels of free serum testosterone were 9.9 and 10.0 pg/mL, respectively ( P > 0.05). The cancer detection rate in hypogonadal patients was 41.3% (33/80) and 46.0% in eugonadal patients (183/398) ( P > 0.05). The median level of total testosterone was 433 ng/dL in patients with low-risk prostate cancer, 467 ng/dL in those with intermediate-risk tumours and 468 ng/dL in those with high-risk tumours ( P > 0.05); the median levels of free testosterone were 9.4, 9.8 and 10.3 pg/mL, respectively ( P > 0.05). CONCLUSIONSProstate cancer risk and tumour aggressiveness are not related to serum levels of total and free testosterone, but hypogonadal patients do not have a greater risk of prostate cancer and tumour aggressiveness.

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ultrasonography-guided biopsy using a 10-core scheme, with an additional 1-8 cores according to prostate volume and patient age. The sT level was determined before the procedure using a chemiluminescent assay, and the ratio of sT to PSA (sT/PSA) was calculated after transforming sT measurements from ng/dL to ng/mL. The percentage free PSA (%fPSA) and PSA density were also included in this analysis. RESULTSThe overall cancer detection rate was 42.1%. The median sT level was 469 ng/dL in men with cancer and 499 ng/dL in those without ( P = 0.521). The median sT/PSA was 0.68 and 0.74, respectively ( P = 0.215). However, the median %fPSA was 14 in men with cancer and 17 in men without ( P < 0.001) and the median PSA density was 0.22 and 0.16, respectively ( P < 0.001). The multivariate analysis confirmed the independent predictive value only for %fPSA (odds ratio 0.94, 95% confidence interval 0.91-0.98) and PSA density (5.8, 3.42-19.8). CONCLUSIONThese results do not support the use of sT/ PSA for predicting the risk of prostate cancer and to increase the specificity of PSA.

The new generation of hip approaches have a strong anatomical basis, hip capsule preservation is a revolutionary concept, it ensures anatomical restoration, length and offset near to native joint. The Superpath® potentially minimises morbidity, reducing transfusion rates, allowing rapid recovery, shortening hospital stay and could save a significant cost to the healthcare system.